“You’re looking at six or seven years’ worth of work and just a year’s worth of insurance to cover all that.”

Rena Rabheru

dentist

Sameer S. Zaheer has been chewing on one side of his mouth since March to avoid putting pressure on a bad tooth. He expects to keep it up until October.

He needs a root canal, but he won’t have it until the fall when the benefits kick in at his new job as a software engineer.

“It was very inconvenient for the first few weeks, and then I just got used to it,” said the 24-year-old man. “You can just shift everything to one side of your mouth pretty easily.”

In a tough, post-recession employment market, job benefits are increasingly rare for many in their 20s and 30s, and they are paying the price with their teeth.

Post-secondary graduation spells the end of student insurance or parents’ coverage, and many millenials are struggling to lock down a job with a dental plan.

Just under a third of Canadians aged 20 to 39 hadn’t been to the dentist in over a year, according to a 2010 Health Canada report. Young adults are the least likely to get to the dentist on a regular basis, followed by those 60 to 79. At the other end of the spectrum, the survey found that 91 per cent of children 6 to 11 had been to the dentist in the last year.

Six months after she started her dental practice at Dentistry in the Beach, Rena Rabheru noticed a wave of patients between 28 and 35 coming in after years without coverage. That means a routine cavity can spiral into $5,000 worth of dental work.

That’s what happened to Zaheer whose problem started with a cavity when he was 10 or 11. The filling didn’t last. “It just randomly popped out,” he said.

He held off on the $700 root canal the dentist ordered, because he had maxed out the $500 annual coverage he got as a University of Toronto student.

Rabheru said she’s been surprised at the amount of dental work required by some patients following a hiatus.

“You’re looking at six or seven years’ worth of work and just a year’s worth of insurance to cover all that,” she said.

Rabheru remembers doing a tooth extraction on a 32-year-old healthy man who hadn’t been to the dentist in eight years. “He put off his dental treatment for so long that by the time he came to me the tooth wasn’t saveable,” she said.

When a patient has limited coverage, Rabheru spells out what needs to be done, but must sometimes prioritize.

Dr. Peter Doig, president of the Canadian Dental Association, confirmed a lack of dental care among those in the early years of their working careers.

“They either come back to the office when something becomes of a pressing nature or when they’re more financially able to afford dental care or get their first employment that gets them a dental plan,” Doig said.

“For those in their 20s and 30s, today’s labour market is fundamentally different from the one their parents knew,” says a report from McMaster University and United Way Toronto. It found that barely half of Toronto- and Hamilton-area workers have permanent, full-time work with benefits. Unstable employment is up 50 per cent over the last 20 years.

Shahzana Ahmed, 28, loves her job as a university program assistant. But it’s her fourth job without benefits at Ryerson in three years. The last time she went to the dentist, in September 2011, she was told she needed further work.

“The first installment of the procedures that they would like me to get done was $1,000,” said Ahmed. She didn’t book a follow-up appointment.

Ahmed was covered by her father’s dental plan until she was 25, hitting the Canadian standard cut-off age for young adults on their parents’ insurance.

Young adults are typically classified as dependents until they’re 21, or 25 if enrolled in post-secondary education, said Bill Walker of Blue Cross Ontario.

Insurance is the greatest predictor of dental care, said Carlos Quiñonez, assistant professor at the University of Toronto’s Faculty of Dentistry, who specializes in dental public health. “The shifting nature of employment — if it keeps going the way it is right now — will make it more difficult for millennials to be able to go to the dentist simply because the insurance market is not what it used to be,” he said.

There might also be an income divide at play too.

Millennials who are stuck without dental coverage for the first time in their lives tend to be from middle- and higher-income backgrounds, said Quiñonez.

People from lower-income backgrounds, on the other hand, have had poor coverage most of their lives.

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